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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br />Date Reooived . <br /> <br /> <br /> <br />Owner's Name <br /> <br />Owner'sAddress I 4928 19th street Z-Hills 11S42 <br />Fee Simple Titleholder Namel <br /> <br />Fee Simple Titleholder Address <br /> <br />JOB ADDRESS <br /> <br />4928 19th st. <br /> <br />WORK PROPOSED <br /> <br />B <br />D <br />D <br />I Upgrade service to 150 amps. <br />I SQ FOOTAGE I <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />Zephvrhills. FL 33542 LOT # <br /> <br />I PARCELlD#11 4-26-21-001 0-OQ1 00-011 0 <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />B ~~~~~T [j] SIGN D MOVE D <br /> <br />c==J COMM D OTHER I <br />c==J FRAME D STEEL D <br /> <br />SUBDIVISION <br /> <br />DEMOLISH <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />OTHER I <br /> <br />DESCRIPTION OF WORK <br /> <br />BUILDING SIZE <br /> <br />HEIGHT I <br /> <br />'.'.,1......'....1.....1,..1....1....111,..,111....,11..1,...,11....1,...1,..'...1....1."..,11.".,'.'.....'.11,..,1,....".1111..,....,....,.,..1. <br /> <br />BUILDING <br /> <br />1$ <br /> <br />1$1.150.00 <br /> <br />1$ <br /> <br />1$ <br /> <br />c=J GAS D <br />FINISHED FLOOR ELEVATIONS I <br /> <br />c=J <br /> <br />[X] <br />c=J <br />c=J <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />ELECTRICAL <br /> <br />AMP SERVICE 1 5 0 <br /> <br />GW <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W.R.E.C. <br /> <br />PLUMBING <br /> <br />MECHANICAL <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />ROOFING <br /> <br />c==J <br />I <br /> <br />SPECIALTY D OTHER <br />FLOOD ZONE AREA DYES <br /> <br />DNO <br /> <br />1,..""....."..,11.11",..,1"."1..,.,'11.'.".....ft'II"""""""""""""-"'I"""""""'",....,111.,"'1...,1'"",..."1".,.11 <br /> <br />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />ELECTRICIAN '. <br />SIGNATURE <br /> <br /> <br />~ <br /> <br /> <br />License # <br /> <br /> <br />~erse Electrical, I~C_ <br />_ Y / N _ FEE CURRENT Y / N I <br /> <br />License # kC1 3001 353/ <br /> <br />Address <br /> <br />144q <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y / N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y / N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />111111111111111 11I111111111111111I11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I111111 <br />RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permit for new construction, <br />Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, <br />Sanitary Facilities & 1 dumpster; Site Work Permit for sUbdivisionsllarge projects <br />COMMERCIAL Attach (3) complete sets of Building Plans plus a Life Safety Page; (1) set of Energy Forms. R-Q-W Permit for new construction. <br />Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, <br />Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance <br />SIGN PERMIT Attach (2) sets of Engineered Plans. <br />""PROPERTY SURVEY required for all NEW construction. <br />111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I1111111111111111 <br />Directions: <br />Fill out application completely. <br />Owner & Contractor sign back of application, notarized <br />If over $2500, a Notice of Commencement is required. (AlC upgrades over $5000) <br /> <br />Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same <br /> <br />OVER THE COUNTER PERMITTING (Front of Application Only) <br />Reroofs Sewers Service Upgrades NC Fences (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadwaysooneeds ROW <br />